Buccal mucosal graft after posterior lamellar resection for eyelid sebaceous carcinoma

PURPOSE: To evaluate outcomes of single-stage posterior lamellar reconstruction using buccal mucosal grafts after posterior lamellar resection (PLR) for eyelid sebaceous carcinoma. METHODS: Retrospective consecutive case series at an academic center (2020-2025). Patients with histopathologically confirmed sebaceous carcinoma who underwent PLR with immediate buccal mucosal grafting, without other posterior lamellar substitutes, were included. Outcomes included graft integration, eyelid position, ocular surface morbidity, complications, and change in visual acuity (VA). RESULTS: (range 300-1600). Graft integration was successful in 100%. No entropion, ectropion, or new ptosis occurred; lower-lid retraction occurred in one case (7.7%), mild lagophthalmos in two (15.4%). Ocular surface morbidity included neurotrophic keratopathy in three cases (23.1%) and limbal stem cell deficiency in three (23.1%); two (15.4%) required permanent lateral tarsorrhaphy and one underwent evisceration (7.7%). Among nine eyes with paired data, three (33.3%) lost > three Snellen lines. No local recurrence or distant metastasis occurred during follow-up. CONCLUSION: Buccal mucosal grafting provided reliable single-stage posterior lamellar reconstruction after PLR with complete graft integration and generally stable eyelid position; morbidity was driven primarily by ocular surface disease, supporting proactive corneal protection.